Sub-Saharan Africa has long been known to have the highest rates of HIV/AIDS in the world. But recent findings by UCI sociology assistant professor Rachel Goldberg reveal that despite the focus on the region, few estimates exist of one of its most vulnerable populations - children living in households with HIV-infected adults.

Healthcare workers in Sub-Saharan Africa face many challenges in keeping children healthy, including extreme poverty and high levels of disease and illness. The emergence of HIV and AIDS in the region has only exacerbated these challenges.

Goldberg has been taking a closer look at how common it is for children to live in a household with at least one HIV-infected adult. Some of these children may have needs that are distinct from other HIV-affected children. They can have increased exposure to opportunistic infections - such as tuberculosis and pneumonia - and they can be affected by a cascade of events in their households including the diversion of attention and other resources, a change in household responsibilities including the need to provide care, and effects of HIV-associated stigma in schools or communities.

Using demographic and health survey data from 23 countries collected between 2003 and 2011, she has found that the population of children living in a household with at least one HIV-infected adult is substantial where HIV prevalence is high and is largely distinct from the orphan population. In southern Africa, the percentage of children living in a household with at least one HIV-infected adult exceeded 10 percent in all countries and reached as high as 36 percent. Most of those children live with parents, often mothers, who are infected, and in most countries more than 20 percent live in households with at least one infected adult who is not a parent.

Goldberg says she was surprised to find that while children living in households with HIV-infected adults are widely recognized as HIV-affected, most publications that monitor the situation of children in the context of AIDS report only on the prevalence and incidence of pediatric HIV, the percentage of HIV-infected pregnant women receiving treatment, and the prevalence of children who have lost one or both parents to AIDS or other causes. Noting that these are all very important indicators, she says there is so much more to know about children’s experiences.

She predicts that these numbers will not decrease any time soon and that current care and outreach efforts should be examined to assure that the distinct needs of these children are being met.



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